Why U.S is 5 or below while international is 10 and below

JimP · Post by **JimP** » Thu Oct 23, 2014 10:28 pm

I read somewhere on these threads that the target AHI in the U.S. is 5 and below where everywhere else its 10 and below.

Does anyone know anything about this?

Wulfman... · Post by **Wulfman...** » Thu Oct 23, 2014 11:37 pm

JimP wrote:I read somewhere on these threads that the target AHI in the U.S. is 5 and below where everywhere else its 10 and below.

Does anyone know anything about this?

"Everywhere else"? Like in other parts of the world? Are you talking about "successful treatment" levels or diagnosis? Don't know about other countries. But, I believe I have read that there are higher thresholds of diagnosis for older people (seniors) in the U.S., but don't have any links handy.

If you search and find something, let us know what you find. And, if you've got links to the other countries, please post them.
I suspect that if there ARE differences between countries, it's because of the different governing bodies, medical criteria and "influence" by the insurance entities in the respective countries.

Den

.

billbolton · Post by **billbolton** » Fri Oct 24, 2014 3:45 am

JimP wrote:Does anyone know anything about this?

Just one of the urban myths of Sleep Disordered Breathing

johantv · Post by **johantv** » Fri Oct 24, 2014 5:07 am

In the Netherlands an AHI below 5 is also considered ok (no OSAS). Gradations of OSAS are 5-15, 15-30 and 30+.

Lazer1234 · Post by **Lazer1234** » Fri Oct 24, 2014 6:49 am

johantv wrote:In the Netherlands an AHI below 5 is also considered ok (no OSAS). Gradations of OSAS are 5-15, 15-30 and 30+.

It's the same in Sweden

Samaniego · Post by **Samaniego** » Fri Oct 24, 2014 7:38 am

In Honduras it doesn't matter at all.

BlackSpinner · Post by **BlackSpinner** » Fri Oct 24, 2014 7:55 am

Canada 5 or less

johantv · Post by **johantv** » Fri Oct 24, 2014 8:07 am

Samaniego wrote:In Honduras it doesn't matter at all.

does that mean everyone has a pap or nobody?

Samaniego · Post by **Samaniego** » Fri Oct 24, 2014 8:29 am

No one has one. Not even the rich. Only if they are immigrants from rich countries.

No shops are selling machines. No shops are selling supplies. I keep one in U.S.A. and one with family. If I get home and something is broken or missing could only get from U.S. and I do not know how.

Social medicine is very bad. Economy is controlled by government. Too much regulation. Too much debt. Many, many killings. Hard to do business because of many regulations and corrupt government people. A new constitution is needed and new politics. Most people are poor.

johantv · Post by **johantv** » Fri Oct 24, 2014 8:36 am

Sorry to hear...

chunkyfrog · Post by **chunkyfrog** » Fri Oct 24, 2014 9:00 am

Often treatment level depends on the insurance contract.
When I was diagnosed, 15 was the line, but it was 10 with co-morbidities (BCBS)

andy5805 · Post by **andy5805** » Fri Oct 24, 2014 10:58 am

my take on this is as follows

point 1: the 1 to whatever scale is psychological incentive - if our Doctors tell us anything is bad, we get scared, we ensure by our fear that the AHI goes up, the AHI can go up for two reasons, through sleep apnoea or through fear of it going up leading to fragmented sleep which is shallower sleep where the snoring gets us, a self fulfilled prophecy! but for anyone who has had sleep apnoea they don't CARE where it came from it's horrible and it has to go away - wherever the poor sleep came from is equally nasty whether that is blind obedience to a scale and marking yourself out of 5 (or 10) and becoming worried, or through rubbish pressure, or through wrong humidity! we don't care why, we just feel it, which leads to point 2 being the making of point 1...

point 2: this is a positive post not a negative post if you've read this far -the scale is a complete myth otherwise known as how long is a piece of string. if I had an AHI of 12 and a great day at work and met someone who was sleep deprived with an AHI of 3, I'd back my 12 all the way. Sometimes feeling is the only measurement, a number cannot tell me how I have slept - only I can do that, so the scale is both a fraud and a comfort blanket, many follow it, ...but the point we can take home from this is only that the voodoo only works because people think it does!

all the best!
Andy

cathyf · Post by **cathyf** » Fri Oct 24, 2014 12:35 pm

There is also this weird thing where we count events not time in AHI. So Joe falls asleep and sleeps for 55 minutes with no events. Then he stops breathing for 5 minutes. Then he's dead. One event, one hour, AHI is one. But Joe is quite dead. Not mildly dead, not moderately dead, not severely dead...

The other thing we count is oxygen saturation -- that is a much more direct measurement of the problem. If you are having a wild and crazy dream that is causing erratic breathing, but you are keeping your oxygen at 98-99%, that is a lot more significant than the number of events that you are having.

When the insurance, etc. has guidelines and criteria, good medical practice understands that those are good for the "no-brainer" cases. If somebody feels crappy, and has an AHI of 50 and desats to 75%, you don't really need to think that hard. "Guidelines" are supposed to mean that if you have the odd patient who is NOT the no-brainer, then you have to think, and you have to figure out what's really wrong, and you have to justify the treatment. The no-brainer rubber-stamp cases are supposed to save time/energy that you need to think about the weird cases.

palerider · Post by **palerider** » Fri Oct 24, 2014 1:56 pm

cathyf wrote: But Joe is quite dead. Not mildly dead, not moderately dead, not severely dead...

moderately dead, is that like "a little bit pregnant"?

js12278 · Post by **js12278** » Fri Oct 24, 2014 2:58 pm

I have a report that was compiled in January 2008

Sort of Interesting how SOME of it was or is applied
https://cms.fmcsa.dot.gov/sites/fmcsa.d ... ns-508.pdf

Why U.S is 5 or below while international is 10 and below